ABSTRACT By documenting the lifecycle of a French local currency project, we explore the elaboration, maintenance, and rearrangement of values and the role played by tensions in such a process. We draw from a rich, 18-month ethnographic investigation that involved over 400 h of direct participant observation, conducting 23 formal interviews, attending dozens of meetings and events, and collecting emails and online exchanges on the server of the project. Through temporal bracketing, we identified three temporal phases in the development of the local currency: (i) Articulating and sketching out a value-driven organization (May 2013–November 2015); (ii) Framing values through tensions: Two visions at play (December 2015–May 2016); and (iii) Balancing out means and ends: Putting values to the test (June 2016–September 2018). We characterize three forms of values work – Positioning, Convincing, and Rearranging – associated with each of these phases. By examininng how each of this call upon various resources and techniques and are performed by various actors, we show how tensions act as catalysts for values work.

BackgroundCOVID – 19 has had a profound impact on the economy, health systems within countries, and individuals around the world. To provide insight that may enhance the preparedness for future pandemics, a comprehensive cost assessment is vital. This study aims to estimate the direct cost of illness (CoI), as well as the national burden of treating hospitalised COVID-19 patients.MethodsThis study is prevalence-based retrospective study containing all patients admitted to a single designated hospital in Kuwait for the treatment of COVID-19. Micro (bottom-up) and macro (top-down) costing methods were used to evaluate direct medical CoI from a hospital perspective. Cost components were grouped as consumables, equipment, and human resources, and sensitivity analysis was used to account for uncertainty of inputs. The cost per admission was reported in local currency and international dollars (PPP$).ResultsData on 7569 patients was analysed, 52.8% of whom were male, 69.2% were above 41 years, 22% had previously vaccinated for COVID-19, 22% were admitted to the ICU, and 18% had ≥ 3 pre-existing comorbidities. The mean CoI per admission was 12,063 PPP$, with overheads accounting for 45% of this figure, while consumables, human resources, and equipment accounted for 30%, 19%, and 7%, respectively. The sensitivity analysis demonstrated that overall cost uncertainty was primarily driven by variations in human resource costs rather than by uncertainties related to personal protective equipment (PPE) or ventilator use.ConclusionThe substantial economic impact of COVID-19 on Kuwait’s healthcare system has emphasised the significant role human resource costs has on overall expenditure. These findings provide valuable insights for future pandemic preparedness.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13561-025-00694-9.

Accelerated globalization and the thirst for economic emancipation of the people create demographic shifts from developing countries to developed countries. To assist policymakers in effective decision making regarding labor migration and economic growth, our paper explores the hidden dynamics between labor migration and economic growth in Bangladesh from 1988 to 2020. The study was developed based on the Auto Regressive Distributed Lag (ARDL) framework to capture long-run and short-run dynamics among the variables. To find the directional relationship, we also perform the Toda Yamamoto Causality test to find the short-run impact on the dependent variables. The existence of co-integration among the variables is demonstrated by the Bounds test result. The empirical results show the long and short-run positive significant relationship between international labor migration and exchange rate. However, Inflation and GDP growth do not have any significant impact on migrant laborers from Bangladesh to abroad. The causality approach indicates a unidirectional causality between labor migration and exchange rate, GDP growth and exchange rate. This paper suggests that the devaluation of the local currency would be a possible way to boost labor export from Bangladesh.

ABSTRACT Background Low back pain (LBP) is a disabling condition affecting all age groups globally. Exercise is safe and cost-effective for managing LBP. Pilates is an effective exercise modality recommended for LBP but is not reimbursed by the Brazilian Public Health System. This study aimed to estimate the budget impact of implementing Pilates for LBP patients within the Brazilian public health system compared to usual care. Research design and methods A budget impact analysis (BIA) was conducted over a five-year horizon, from healthcare and societal perspectives. Costs were extracted in local currency and converted to international dollars using purchasing power parities. Deterministic sensitivity analyses were performed. Results Over five years, healthcare costs in the usual care were Int$860.8 million, while Pilates reached Int$958 million, resulting in an incremental impact of Int$97.2 million. From the societal perspective, the usual care cost was Int$4.32 billion, and the Pilates scenario was Int$4.15 billion, indicating savings of Int$172.2 million. The incremental budget impact was negative, meaning that Pilates would provide savings of Int$172,203,216. Conclusion Implementing a group-based Pilates program for LBP in the Brazilian public health system would increase healthcare costs by Int$97 million but generate societal savings of Int$172 million over five years.

In an effort to improve cross-border payments and meet the G20 Roadmap target to reduce the global average cost of sending remittances to 3 percent by 2027, this joint IMF-World Bank technical assistance report presents the findings from the August 2024 diagnostic mission to South Africa. The report examines the South Africa-Zimbabwe payments corridor, a critical remittance channel in the SADC region, where remittances are slow and costs remain as high as 12.7 percent. For example, Zimbabwe relies heavily on remittances (9.6 percent of GDP), yet cash dominance—driven by a lack of confidence in the local currency and the inability of migrants to access formal financial services—raises costs and limits digital adoption. Operational challenges, stringent AML/CFT reporting requirements, and limited competition further inflate costs. Recommendations provided by the mission team include, among other things: reducing cash reliance through fast payment systems and interoperability; implementing risk-based AML/CFT measures to improve market access; and enhancing payment infrastructure, interoperability, and regulatory reforms to foster competition, innovation, and financial inclusion.

In emerging markets and developing economies (EMDEs), limited investment in renewable energy remains a major obstacle to electrification efforts. This article explores the risks that deter investments in renewable energy projects in EMDEs. It analyzes data from surveys and interviews with key stakeholders involved in renewable energy development, complemented by data from the World Bank’s Utility Performance and Behavior in Africa Today (UPBEAT) database. Beyond the commonly cited risks and barriers, including a shortage of bankable projects, inconsistent government policies, and weak regulatory frameworks, the findings reveal that off-taker payment risk and currency mismatch are the most significant factors undermining investor confidence. Over 50 utilities in these markets operate with negative net profit margins and face difficulties servicing hard currency debt, largely due to poor revenue collection and substantial technical and commercial losses. Despite these challenges, promising solutions are emerging. Financial instruments such as partial risk guarantees and blended finance are helping to mitigate risks, while the growth of decentralized power markets is creating new investment opportunities. Nevertheless, achieving a sustainable energy transition will also require utilities to improve operational and technical performance, alongside broader adoption of hedging strategies and local currency financing to reduce financial risks across the sector.

Abstract Modern monetary theory (MMT) argues that all governments that issue their own currency have the same fiscal and monetary policy space. This paper argues against this position. For MMT’s assumptions to be valid, MMT must abstract from the gravitational force of the US dollar that stems from it being backed by a mass of securities – an influence transmitted through international investment flows. Once the dollar’s gravitational force is recognised, it becomes clear that the huge size disparity separating the US financial market from those of other markets, and most notably those of the emerging market economies (EMEs), translates into an equally huge disparity regarding fiscal and monetary policy capacities. The strategic implications of recognising this disparity are that EME governments should, where possible, join their financial markets into regional blocs of sufficient size to give their regional currencies enough backing mass to allow them to resist the gravitational pull of the dollar. Only by pooling their currency sovereignty can EME governments retain some scope for pursuing macroeconomic policies independently of those pursued by the US government. Without doing so, if EME governments in countries with small financial markets follow MMT’s advice to retain their local currencies, this will condemn these currencies to entrapment in the dollar’s gravitational field and possibly outright dollar colonisation.

BackgroundHeadache is a public health problem in Africa and is a significant cause of neurological consultations, imposing a heavy burden. Data on its actual economic burden are scarce in Africa. This study aims to evaluate the direct cost of headache management in 2023 and to identify factors associated with the high direct cost of headache management.MethodsThis cohort study with descriptive and analytical aims was conducted from June 15 to October 15, 2023, in the neurology unit of the teaching hospital of Borgou in Parakou, on 91 subjects with headaches, including migraine, tension type headache, trigeminal neuralgia, cluster headache, paroxysmal hemicrania and secondary headache. Any patient who had experienced headaches in the past 12 months, who was aged at least 18 years and who provided informed consent was included. The direct cost of headache management was defined as the sum of costs by consumption level category (consultation, diagnostic tests, treatments, transport, hospitalization costs, other nonmedical costs) and the monetary value of the main companion. This cost was expressed in Benin’s local currency (West African francs XOF), with a corresponding amount in euros. The direct cost of headache care was considered high when the mean monthly direct cost was more than 10% of the guaranteed minimum wage in Benin. Consumption level data were collected through an individual interview, supplemented by a review of medical records, notebooks, and receipts for headache management. Data entry was carried out via the KoboCollect application. Data analysis was performed using EpiInfo 7.2 software.ResultsA total of 91 participants were included, with 51 women (56.04%). The mean age was 38.91 ± 14.52 years. The monthly direct cost estimated one month after inclusion was high, calculated at XOF1,599,400 (€2,438.26), with an average of XOF17,575.82 ± 10,290.68 (€26.79 ± 15.69), representing 33.80% of the minimum wage in Benin. The global annual direct cost of headaches was XOF15,537,875 (€23,687.23) with a higher cost for tension type headaches at XOF6,077,530 (€9,265.09), whereas that of migraine was calculated at XOF4,603,970 (€7,018.67). The factors associated with high costs of headache management were a history of anxiety (p = 0.02), the presence of comorbidities (p = 0.005), the frequency of attacks (p = 0.048), and consumption related to psychiatric consultation (p = 0.02).ConclusionThe direct cost of managing headaches is high, with multiple associated factors. Strategies aimed at reducing this cost are urgently needed to optimize management and influence national public health policy for headache patients in Benin.

By 2024, Albania’s food and non-alcoholic beverage prices reached 100% of the EU average, up from 68% in 2012, despite a nearly 30% ‎appreciation of the local currency. This was the sharpest increase in food prices recorded in the Balkans during the period, despite the country recording similar growth rates to the regional average. Food prices in Albania are today at levels higher than in countries such as the ‎Netherlands and Spain, which have significantly higher GDP per capita and household wellbeing than Albania (GDP per capita at 35% of ‎the EU average, second from last in the Balkans). In 2024, Albanian families, who allocate nearly 40% of their income to food, face price levels comparable to those of much wealthier EU households. This study provides a robust, regression-based comparative analysis of food price inflation ‎in Albania from 2013 to 2024, benchmarking trends against the European Union (EU), key EU trade partners (Italy, Greece, Germany), and ‎Western Balkan economies. It compares food inflation dynamics across two periods, pre-COVID (2013–2021) and post-COVID (2022–‎‎2024), and evaluates the role of currency appreciation in moderating domestic price pressures. Using harmonized consumer price data and ‎exchange-rate-adjusted regression models, the study reveals that Albania’s food prices have risen earlier, faster and more persistently than in ‎its peer countries, even as the Albanian lek appreciated nearly 30% over the decade. While food price movements in Albania appear to align ‎with EU trends, statistical modeling shows a significantly stronger elasticity and an amplified domestic response, particularly before 2021. ‎Once exchange rate effects are accounted for, Albania’s correlation with EU food prices collapses, unlike in other Western Balkan countries ‎or EU trade partners, indicating that FX gains were not passed on to consumers. These findings provide strong empirical evidence that Albania’s inflation outcomes are not simply imported but are domestically amplified due to weak market competition, non-transparent pricing, and limited regulatory oversight. The paper concludes that internal structural issues have muted the pass-through benefits of currency appre‎ciation to consumers, while price increases closely followed the trend observed in the EU. This underscores the need for stronger competi‎tion policy and more inclusive market mechanisms to ensure that macroeconomic gains support household welfare. The paper is especially ‎relevant to policymakers, central banks, international institutions, and researchers seeking to understand how structural inefficiencies can ‎offset macroeconomic advantages in small economies‎.

This research article presents innovative strategies to address poverty, hunger, inflation, high cost of living, and sustainable support for developing nations without debt accumulation. It proposes a multi-faceted approach to tackle these global challenges through technology-driven and community-based solutions. For poverty and hunger, Community Food Trusts (CFTs) leverage partnerships to redistribute surplus food, aiming for a 30% reduction in urban food insecurity. Micro-Entrepreneurship Incubators (MEIs) foster self-employment with mentorship and microloans, targeting a 40% increase in job creation. Mobile Health Clinics with AI diagnostics aim to enhance healthcare access by 50% in underserved regions, while Peer-Led Learning Hubs (PLLHs) improve education retention by 35%. Digital Skills Mobilization (DSM) programs train youth for remote work, projecting a 45% employment boost. To combat inflation, strategies include Dynamic Digital Currency Adjustment (DDCA) using blockchain, Decentralized Autonomous Supply Chains (DASCs) for cost efficiency, Inflation-Indexed Universal Basic Income (IIUBI) to maintain purchasing power, AI-Driven Price Monitoring to ensure market fairness, and Community-Based Local Currency Systems to bolster local economies. For global support, the article suggests technology transfer partnerships, sustainable investments via a Global Green Investment Fund, human capital development, fair trade agreements, digital infrastructure grants, and global health collaborations. These strategies, supported by diagrams illustrating their mechanisms, aim to foster economic resilience and equitable growth without increasing debt burdens, promoting collaboration between developed and developing nations for sustainable global prosperity.

To decide on the acceptability and usability of ZiG on the Zimbabwean market, the paper traces the history of the use of the local currencies and the operation of the Reserve Bank of Zimbabwe’s monetary policy dating back to 1980. The history made it clear that there was poor monetary policy by the Reserve Bank of Zimbabwe which compelled the people to lose confidence in the use of any future local currencies. This research adopted a qualitative research approach. Primary data supplemented secondary data. The research population consists of all Chinhoyi residents above 18 years and a convenience sampling method was chosen to select respondents. Four focus group discussions (FGDs) were done, and a questionnaire was distributed to key informants. Observations were also done to argument FGDs and the questionnaire. The research revealed that populace does have confidence in the use of ZiG instead prefers to use foreign currencies. The main drivers for this lack of confidence in the use of ZiG was noted as emanating from citizens past experiences in the use of local currency and the high inflation rates associated with local currencies. The paper, thus, provides some policy recommendations on how best to boost the acceptability and usability of ZiG.

In the context of global economic integration, exchange rate fluctuations have become more frequent and volatile, posing significant challenges to the export-oriented economies of emerging markets. These fluctuations affect export competitiveness, market demand, and corporate profitability. This paper examines the impact of exchange rate fluctuations on exports from emerging economies using data from 2010 to 2022. It finds that short-term sharp fluctuations undermine export competitiveness, while long-term misalignment reduces export volume by an average of 2.7% annually, with high-tech products being 42% more affected than primary products. Corporate profitability responds asymmetrically: a 10% depreciation of the local currency boosts profit margins by 1.5%, whereas an equivalent appreciation cuts them by 3.2%. Based on these insights, this paper suggests establishing a comprehensive response system through financial instruments, dynamic pricing, and market diversification. The study shows that market diversification can reduce risk exposure by 28%, and increasing supply chain localization by 10% can enhance risk resistance by 5.6%, offering references for policy and strategy formulation.

Social isolation is consequential for human health and well-being. However, global trends and trends across countries, regions, and socioeconomic strata remain inadequately characterized, limiting targeted policy responses. To quantify global changes in social isolation from 2009 to 2024 across within-country income groups and evaluate cross-country and regional variation in isolation levels and trends. This cross-sectional study used data from 2009 to 2024 from the Gallup World Poll, a globally representative repeated cross-sectional survey with consistent methodology across more than 150 countries. A random sample of approximately 1000 adults (age ≥15 years) within each country was selected at each annual assessment. Global trends in isolation were examined for the full sample and for top and bottom income groups, defined within each country. The prevalence of social isolation at each time point within each country was assessed as the proportion of respondents who answered "no" to having relatives or friends available to help in times of trouble. Household income was assessed in local currency and coded into 5 quintiles. The study findings are based on data from 2 483 935 person-level assessments (mean [SD] age, 41.7 [17.9] years; 53.1% women) across 16 time points and 159 countries. Prepandemic global mean isolation levels were stable. A marked increase in isolation occurred between 2019 and 2020, concurrent with the onset of the COVID-19 pandemic, and was disproportionately seen in lower-income groups (β = 2.6 percentage points [95% CI, 0.9-4.4 percentage points]; P = .003; an 11.0% increase). From 2020 to 2024, isolation continued to increase, with steeper increases among higher-income groups (β = 1.9 [95% CI, 0.7-3.1]; P < .001; a 12.3% increase). The global prevalence of social isolation increased by 13.4% from 2009 to 2024 (from 19.2% [95% CI, 17.3%-21.6%] to 21.8% [95% CI, 19.4%-24.2%]), with the entire increase occurring after 2019. The disparity in isolation prevalence between high- and low-income groups peaked in 2020: 26.4% (95% CI, 23.6%-29.2%) of lower income groups were isolated vs 15.6% (95% CI, 13.6%-17.7%) of higher income groups. By 2024, global isolation was 2.6 percentage points (95% CI, 0.7-4.5 percentage points) above prepandemic levels and the income disparity was 8.6 percentage points (95% CI, 5.1-12.1 percentage points). A total of 54 countries experienced worsening isolation and widening disparities, while 41 saw improvements. In this cross-sectional study, social isolation was found to have increased globally after the COVID-19 pandemic, with the initial increase disproportionately seen in lower-income populations and subsequent increases broadening across socioeconomic strata. Targeted interventions for vulnerable groups and research examining country-level policies are urgently needed to mitigate high isolation levels and reduce inequities.

Evaluating the Cost-Effectiveness of Pharmacological Therapy in Alzheimer Disease in Brazil.

Geopolitical risk and offshore corporate bond issuance in local currency

New spare tires: local currency credit as a global shock absorber

At the request of the authorities, an IMF-World Bank team undertook a technical assistance mission to Bangladesh, from July 5-17, 2023, to support efforts to develop the government local currency bond market. The mission assessed the current stage of the sovereign debt market and formulated policy recommendations for each of the six building blocks included in the Guidance Note for Developing Government Local Currency Bond Markets.

Small and medium-sized enterprises (SMEs) function in unstable macroeconomic contexts, especially in emerging markets characterised by significant economic volatility. SMEs are crucial for job creation and poverty alleviation; however, they encounter various challenges that impede their growth. Small and medium-sized enterprises in the Mashonaland West Province of Zimbabwe face limitations due to political and economic instability. This research examines operational challenges through a qualitative methodology. Data were gathered from 21 purposefully selected SME owner-managers, each possessing a minimum of five years of managerial experience, across five districts. Inductive thematic analysis, facilitated by NVivo software, was employed to examine open-ended interview responses. Identified key obstacles include cash shortages, inadequate working capital, elevated inflation, foreign currency limitations, increasing costs, and inconsistent government policies. Recommendations for policy include the revision of monetary policy, stabilisation of the local currency, adjustment of tax structures, and enhancement of price control mechanisms. Managers of small and medium enterprises are advised to enhance cash flow and inventory management practices. Future research should undertake comparative studies among developing countries.

This study examines the issue of dedollarization in Indonesia, focusing on the challenges and opportunities for strengthening the Islamic economy. Dedollarization, defined as reducing dependency on the US dollar in economic and financial transactions, is a crucial strategy for enhancing national economic independence. In the context of the Islamic economy, dedollarization presents opportunities to reinforce a financial system based on Islamic values, which emphasize justice, transparency, and sustainability. This research employs a qualitative approach using literature review and policy analysis methods. The findings indicate that the main challenges of dedollarization in Indonesia include dependence on dollar-based international trade, domestic currency stability, and the limited financial infrastructure to support this transition. However, significant opportunities are also evident, such as the vast potential of the Islamic economy market, supportive government regulations, and increasing public awareness of the importance of an economic system rooted in Islamic principles. The implications of dedollarization for the Islamic economy include enhancing the competitiveness of Islamic financial institutions, expanding the use of local currency in international transactions, and strengthening the halal ecosystem in Indonesia. This study recommends strengthening government policies, fostering collaboration among Islamic financial institutions, and educating the public to support a gradual and integrated dedollarization process.

Decreasing trends in the external worth of most currencies and an oil price surge have been accompanied by a persistent increase in food prices and transportation costs. In 2023, Sub-Saharan Africa (SSA) had a growth rate of 3.3 percent (IMF, 2023), yet the region experiences long-lasting external shocks in addition to domestic shocks. The goal of this study is to clarify the dynamic effects of devaluation of exchange rates and oil price shocks on the prices of food and fuel consumption in eleven SSA emerging nations while also examining the causality's direction. The study also seeks to ascertain whether there is a threshold for oil prices based on the relationship between oil prices, currency rates, and food consumption. We estimated the Markov Autoregressive Regime Switching Model (MARSM) with monthly data from 2000Q1 to 2024Q2. The research findings provide an informed basis for re-assessing the monetary policy rate in order to control inflation in Nigeria. In particular, the study establishes that the conventional theoretic view of monetary policy transmission, whereby higher interest rates translate to reductions in inflation, is misleading for SSA. The study established the presence of a domino effect, which embraces excessive depreciation of local currencies, causing high consumer price inflation that leads to rising costs of living in the midst of a foreign exchange shortage. For a sensitivity analysis, we disaggregated the consumer price inflation rate into food inflation and fuel consumption price to have food CPI and fuel CPI and estimated the panel GMM model for our panel of ten nations. The importance of transition probabilities in comprehending food price inflation validates the model's validity. The results validate the presence of a significant causation effect of currency depreciation, oil price surges, and interest rate differentials on the price of food and fuel in SSA. It is advisable to take into consideration the established fact that the amount of surplus reserves in emerging nations serves as the primary anchor for their currency rates. Therefore, exchange rate stability might be attained even in the face of declining oil revenue by making a deliberate effort to diversify the economy's export base and expand infrastructure.